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Related Concept Videos

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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Related Experiment Video

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Evaluation of Capillary and Other Vessel Contribution to Macular Perfusion Density Measured with Optical Coherence Tomography Angiography
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[Retinal vessel density in primary open-angle glaucoma with a hemifield defect].

X L Wang1, X H Sun1

  • 1Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China.

[Zhonghua Yan Ke Za Zhi] Chinese Journal of Ophthalmology
|March 15, 2021
PubMed
Summary

Primary open-angle glaucoma (POAG) patients with visual field defects show reduced retinal vessel density. This vascular dysfunction and thinning of the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) may precede visual field loss.

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Retinal Imaging

Background:

  • Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
  • Early detection and understanding of POAG pathogenesis are crucial for effective management.
  • Visual field (VF) defects in POAG are often preceded by structural and functional changes in the retina.

Purpose of the Study:

  • To investigate retinal vessel density in POAG patients with single-hemifield VF defects.
  • To correlate retinal vessel density with retinal nerve fiber layer (RNFL) thickness and VF indices.
  • To explore the relationship between microcirculation changes and structural damage in early POAG.

Main Methods:

  • Cross-sectional study involving 28 POAG patients and 31 controls.
  • Optical coherence tomography angiography (OCTA) to assess peripapillary radial peripapillary capillaries (RPC) and macular superficial retinal capillary plexus (SCP) vessel density.
  • RNFL and retinal ganglion cell complex (GCC) thickness measurements using OCT.
  • Standard automated perimetry for visual field (VF) assessment.

Main Results:

  • POAG eyes exhibited significantly lower peripapillary RPC and macular SCP vessel densities compared to normal eyes.
  • RNFL and GCC thicknesses were significantly reduced in POAG eyes.
  • Even the unaffected hemisphere in POAG patients showed reduced vessel density and thinning of RNFL and GCC compared to controls.
  • No significant difference in mean deviation or pattern standard deviation of VF between the normal hemisphere of POAG eyes and normal eyes.

Conclusions:

  • Retinal vessel density is reduced in POAG eyes, even with single-hemifield VF defects.
  • Reduced retinal microcirculation and structural thinning (RNFL, GCC) are present in the normal-appearing hemisphere of POAG eyes.
  • Vascular dysfunction and structural changes may precede detectable visual field loss in POAG, highlighting potential early biomarkers.